OMB No. 0910-0711
Expiration Date: 10/31/2013
PUBLIC Disclosure Burden Statement
Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to:
Department of Health and Human Services
Food and Drug
Administration
CFSAN/PRA Comments/HFS-24
5100 Paint Branch
Parkway
College Park, MD 20740-3835.
[PROG: NEW SCREEN]
Thank you for responding to the invitation to participate in this survey on a recent foodborne illness outbreak or food product recall.
Please be assured that all of your answers are kept confidential and no personal identifying information is retained with your answers. If any part of the survey makes you uncomfortable, please feel free to stop at any time.
We are interested in what you have heard about the current outbreak of illness from ++Salmonella++ in ++cantaloupe ++. We are interested in ++cantaloupe++ that you would buy at a store or have at a food establishment away from home. This survey will take about 10 minutes to complete. Please allow enough time to complete the entire survey in one sitting. All responses will be kept confidential.
[PROG: NEW SCREEN]
1. Have you heard or read anything in the ++last week++ about health risks related to eating raw ++cantaloupe ++? That is, have you heard or read anything in the ++last week++ that some cantaloupe is potentially contaminated with disease-causing organisms?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
1a. Have you heard or read anything in the last week about a ++cantaloupe++ recall? That is, have you heard or read anything in the last week about returning cantaloupe to the store, or discarding cantaloupe that is potentially contaminated with disease-causing organisms?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
2. Have you seen anything on television in the last week about a ++cantaloupe ++ recall?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
3. Have you seen anything in the newspaper in the last week about a ++cantaloupe ++ recall?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
4. Have you seen anything on the internet in the last week about a ++cantaloupe ++ recall?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
4a. Have you heard anything on the radio in the last week about a ++cantaloupe ++ recall?
1. Yes
0. No
98. Don’t know
[PROGRAMMER - If Q1 thru Q4a= “0-NO/Don’t Know or missing” (did not hear about recall thru ANY media at all), skip to Q12, OTHERWISE CONTINUE]
[PROG: NEW SCREEN]
We want to ask about what you remember about the outbreak of illness from ++Salmonella ++ and the ++cantaloupe ++ recall.
[prog: please add the punctuation (.) to this screen -]
[PROG: RANDOMIZED 5a/6a to 5f/6f. anchor 5g/6g]
[PROG: NEW SCREEN]
5a. Did you hear “Do not eat any ++cantaloupe ++”?
1. Yes [CONTINUE – ASK 6a]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6a. How likely are you to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
[PROG: NEW SCREEN]
5b. Did you hear “Do not eat certain types of ++cantaloupe ++ ”?
1. Yes [CONTINUE – ASK 6b]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6b. How likely are you to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
[PROG: NEW SCREEN]
5c. Did you hear “Do not eat certain brands of ++cantaloupe ++ ”?
1. Yes [CONTINUE – ASK 6c]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6c. How likely are you to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
[PROG: NEW SCREEN]
5d. Did you hear “Cook ++cantaloupe ++ well before eating”?
1. Yes [CONTINUE – ASK 6d]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6d. How likely are you /would you be to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
[PROG: NEW SCREEN]
5e. Did you hear “Return ++cantaloupe ++ to the food store”?
1. Yes [CONTINUE – ASK 6e]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6e. How likely are you /would you be to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
[PROG: NEW SCREEN]
5f. Did you hear “Discard ++cantaloupe ++ ”?
1. Yes [CONTINUE – ASK 6f]
0. No [Go to next the question in the q5a-q5g series]
98. Don’t know [Go to next the question in the q5a-q5g series]
6f. How likely are you /would you be to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
[PROG: NEW SCREEN]
5g. Did you hear something else about ++cantaloupe ++?
Please elaborate OPEN ENDED ALLOW MORE SPACE FOR OPEN ENDED ANSWER- non-mandatory]
1. Yes [CONTINUE – ASK 6g]
0. No [Go to Q7]
98. Don’t know [Go to Q7]
6g. How likely are you to follow that advice? Would you say . . .?
1. Not very likely,
2. Somewhat likely, or
3. Very likely
8. Don’t know
9. Did not hear advice
[PROG: NEW SCREEN]
7. Did you seek out any of the following sources for information about the ++cantaloupe ++ recall?
[RANDOMIZATION]
|
Yes |
No |
Don’t know |
7a. The Centers for Disease Control, or CDC, website |
|
|
|
7b. The Food and Drug Administration, or FDA, website |
|
|
|
7c. The U.S. Department of Agriculture, or USDA, website |
|
|
|
7d. The FoodSafety.gov website |
|
|
|
7e. News websites |
|
|
|
7f. Food company websites |
|
|
|
7g. The Centers for Disease Control, or CDC, 1-800 number |
|
|
|
7h. The Food and Drug Administration, or FDA, 1-800 number |
|
|
|
7i. Your State department of health |
|
|
|
7j. Newspapers or television |
|
|
|
7k. Blog articles, podcasts, or other social media sources |
|
|
|
7l. Your local grocery store or food market |
|
|
|
[PROG
1. Yes
0. No
98. Don’t know]
[PROG: NEW SCREEN]
8. How informed would you say you are about the current ++cantaloupe ++ recall , if 1 means you are not at all informed and 10 means you are very well informed?
1- Not at all informed
10-Very well informed
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
9a. On the same 10-point scale, how informed would you say you are about….
Select one for each statement
[PROG: GRID TOP, RESPONSES]
Not at all informed
Very well informed
98. Don’t know
[PROG: LEFT, STATEMENTS RANDOMIZED]
a. The causes of ++Salmonella++ contamination in the current ++cantaloupe ++ recall
b. What the government is doing to find the source of the ++Salmonella++ problem for the ++cantaloupe ++ recall
c. What manufacturers/retailers are doing to find the source of the ++Salmonella++ problem for the ++cantaloupe ++ recall
[PROG: NEW SCREEN]
9b. On the same 10-point scale, how informed would you say you are about….
Select one for each statement
[PROG: GRID TOP, RESPONSES]
Not at all informed
Very well informed
98. Don’t know
[PROG: LEFT, STATEMENTS RANDOMIZED]
d. The number of U.S. States involved in the ++cantaloupe ++ recall.
e. Whether the State where you live is involved in the ++cantaloupe ++ recall.
f. What the government is doing to make sure the ++cantaloupe ++ recall doesn’t happen again
g. Ways to protect yourself from ++cantaloupe ++ contaminated with ++Salmonella++
[PROG: PLEASE MAKE GRIDS SCALE LOOK AS EVEN AS POSSIBLE]
[PROG: NEW SCREEN]
10. Using a 10-point scale, how informed about the current ++cantaloupe ++ recall would you say are the grocery stores or markets where you usually purchase food?
1 Not at all informed
10-Very well informed
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
11. Using a 10-point scale, how safe do you think it is to eat ++cantaloupe ++ associated with the ++cantaloupe ++ recall?
1- Not at all safe
10-Very safe
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
12. In the past year, have you eaten raw ++cantaloupe ++?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
13. In the past month, did you eat any raw ++cantaloupe ++?
1. Yes
0. No
98. Don’t know
98. Don’t know
[PROG: NEW SCREEN]
14. Have you eaten any raw ++cantaloupe ++ this week?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
15. Do you currently have any raw ++cantaloupe ++ in your home?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
16. Would you say that raw ++cantaloupe ++ is a regular part of your daily food intake?
1. Yes
0. No
98. Don’t know
17. Weekly food intake?
1. Yes
0. No
98. Don’t know
18. Monthly food intake?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN - PLEASE NOTE: Q16/Q17 AND Q18 ON THE SAME SCREEN]
[PROG: If Q1 thru Q4a=”0-NO” (did not hear about recall thru ANY media at all), skip to Q24, OTHERWISE CONTINUE]
19. Since hearing about the recall, have you changed how much raw ++cantaloupe ++ you eat? Are you eating:
Select one best answer
1. More raw ++cantaloupe ++ .
2. The same amount of raw ++cantaloupe ++ .
3. Less raw ++cantaloupe ++ .
4. No raw ++cantaloupe ++ at all since hearing about the recall.
5. Only raw ++cantaloupe ++ that is not part of the recall.
8. Don’t know
[PROG: PLEASE REMOVE RANDOMIZATION; AND REMOVE PERIODS (.) AT THE END OF THE ANSWER CHOICE]
SINGLE PUNCH,
ANCHORE “DON’T KNOW”]
[PROG: NEW SCREEN]
[PROG: IF Q19 IS CODE 4 “If you selected “no raw ++cantaloupe ++ at all”, ASK Q19a, THEN Q20, OTHERWISE, SKIP /GO TO Q19b]
19a.Which of the following is true? I have not eaten raw ++cantaloupe ++ because.. .
.Choose all that applies
19.a.1. No particular reason
19.a.2. I have not had a taste for ++cantaloupe ++
19.a.3. I have not had the opportunity
19.a.4. I want to avoid becoming ill
19.a.5. I want to follow the health advisory
19.a.6. ++cantaloupe ++ is unavailable for purchase
[PROG: RANDOMIZED STATEMENT]
[PROG: NEW SCREEN]
19b. Since hearing about the recall, have you changed how often you eat ++cantaloupe ++?
Have you eaten ++cantaloupe ++ select one best answer
1. More often.
2. As often as usual.
3. Less often.
8. Don’t know
[PROG: NEW SCREEN]
20. Once you hear that the ++cantaloupe ++ available in stores and restaurants are no longer part of the problem that caused the outbreak of illness from ++Salmonella ++ outbreak, how soon will you resume eating ++cantaloupe ++?
1. I have not stopped eating raw ++cantaloupe ++
2. Immediately or as soon as I have an occasion to eat it
3. I plan to wait awhile.
4. I do not intend to eat raw ++cantaloupe ++ again.
[PROG: NEW SCREEN]
21. If you were unable to eat raw ++cantaloupe ++ for three months, do you have other foods to choose from that could easily take its place?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
22. On a 10-point scale, how difficult would it be for you and your family to limit how much you eat of raw ++cantaloupe ++? Would you say…
1 Not at all difficult
10 Very difficult
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
23. Does what you know about the ++cantaloupe ++ recall make you more or less likely to eat at restaurants, or does it have no impact?
1. More likely
2. Less likely
3. No impact
[PROG: NEW SCREEN]
24. On a scale from strongly disagree to strongly agree, please indicate your response about the following
24a. I want to prevent foodborne illnesses (or getting sick from food)
Strongly disagree
10 Strongly agree
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
24b. I want the ability to protect myself from foodborne illnesses (or getting sick from food)
Strongly disagree
10 Strongly agree
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
24c. I really don’t care about foodborne illnesses (getting sick from food)
Strongly disagree
10 Strongly agree
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
]
[PROGRAMMER - If Q1 thru Q4a= “0-NO /Don't Know or missing”( (did not hear about recall thru ANY media at all), skip to Q32, OTHERWISE CONTINUE]
25. In terms of protecting your health, how important do you think it is to follow the
++cantaloupe ++ recall recommendations?
1 Not at all important
10 Very important
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
26. Do you believe you have the information you need to keep yourself and your family safe from ++Salmonella++ associated with the ++cantaloupe ++ recall?
1. Yes
0. No
98. Don’t know
[PROG: NEW SCREEN]
27. How believable to you is the information about outbreak of illness from ++Salmonella++ from raw ++cantaloupe ++?
not at all believable
10 Completely believable
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
28. How worried are you about becoming infected or getting ill from ++cantaloupe ++ or ++Salmonella++?
1. Not at all worried
2. Not too worried
3. Somewhat worried
4. Very worried
98. Don’t know
[PROG: NEW SCREEN]
29. How angry are you that ++cantaloupe ++ was contaminated with ++Salmonella++
1. Not at all angry
2. Not too angry
3. Somewhat angry
4. Very angry
98. Don’t know
[PROG: NEW SCREEN]
30. Using a 10-point scale, how likely do you think it is that you or members of your family would get sick from eating raw ++cantaloupe ++ associated with the current ++cantaloupe ++ recall?
1 Not at all likely
10 Very likely
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
31. How likely is it that you or members of your family would have serious long-term
health problems from eating raw ++cantaloupe ++ associated with the current ++cantaloupe ++ recall? Would you say…
1 Not at all likely
10 Very likely
98. Don’t know
[PROG: 1 TO 10 HORIZONAL SCALE, WITH DON’T; DO NOT DISPLAY “CODE 98 FOR DK; PLEASE CHECK 1ST PAGE OF PROGRAMING INSTRUCTIONS FOR VISUAL EXAMPLE”]
[PROG: NEW SCREEN]
[PROG: This question is moved to the end and information display even if Q32 is code 1, 0 or 98] in other words, this display is for all respondents.]
[PROG: NEW SCREEN]
33. How many total people, including yourself, live in your household?
(Include foster children, roommates or housemates, and people staying with you last night who have no permanent place to stay. This includes people living with you most of the time while working, even if they have another place to live. Do not include college students living away while attending college, people in a correctional facility, nursing home or psychiatric hospital last night, armed forces personnel living somewhere else, people who live or stay at another place most of the time.
[PROG: Range = 1-97, NUMERIC FIELD. ALSO RAW DATA SHOULD BE NUMERIC]
[ ] [] 98. Don’t know
[PROG: If Q33 <2, skip to Q37, ELSE CONTINUE]
[programmer - please create a logic check to make sure that the sum of the number entered in q34 to q36 is not greater than the number entered in q33]
[PROG: NEW SCREEN]
34. How many children younger than five years old? Please type in number. Enter 0 (zero) if none.
[ ] [] 98. Don’t know
[PROG: (Range = 0-20), NUMERIC FIELD. ALSO RAW DATA SHOULD BE NUMERIC]
35.
Children between 5 and 18 years? Please
type in number. Enter 0 (zero) if none.
[ ] [] 98. Don’t know
[PROG: (Range = 0-20), NUMERIC FIELD. ALSO RAW DATA SHOULD BE NUMERIC]
36. Adults 60 years of age or older? Please type in number. Enter 0 (zero) if none.
[ ] [] 98. Don’t know
[PROG: (Range = 0-20), NUMERIC FIELD. ALSO RAW DATA SHOULD BE NUMERIC]
[PROG: NEW SCREEN]
37. Are you or is anyone in your household pregnant?
1. YES, I am pregnant.
2. Yes, someone in my household is pregnant
3. NO
8. Don’t know
[PROG: NEW SCREEN]
38. Please read the following list of health conditions and indicate if you have been told by a doctor that you have any of them: liver disease, currently receiving chemotherapy or radiation therapy, HIV, AIDS, organ transplant, or weakened immune system.
Yes, I have at least one of the conditions listed.
No, I do not have any of the conditions listed.
DON’T KNOW
[PROG: NEW SCREEN]
39. Please select one of the following. Are you:
[PROG- YOU DO NOT NEED TO ADD “Please select one” to this particular question screen]
0. Male
1. Female
PROG - [ADD A CHECK WHERE RESPONDENT CAN NOT SELECT [MALE] IF “PREGNANT WAS SELECTED IN Q37”
[PROG: NEW SCREEN]
40. What is your age in years?
_______
[PROG: (Range = 18-99), NUMERIC FIELD. ALSO RAW DATA SHOULD BE NUMERIC]
[PROG: NEW SCREEN]
41. What is the highest level of education that you have completed?
1. Less than high school
2. High school graduate or GED
3. Technical/vocational school
4. Community college
5. Some college (1-3 years) towards Bachelor’s degree)
6. College (Bachelor’s degree)
7. Advanced degree (post graduate degree)
[PROG: NEW SCREEN]
42. Are you of Hispanic or Latino origin?
1. Yes
0. No
[PROG: NEW SCREEN]
43. What is your race? You may choose one or more categories. Are you?
1. White
2. Black or African American
3. Asian
4. Native Hawaiian or other Pacific Islander
5. American Indian or Alaska Native
6. Other
[PROG: NEW SCREEN]
32. Would you now like to have more information about the current ++cantaloupe ++ recall advisory?
1. Yes
0 No
98. Don’t know
[PROG: IF Q32= “1-Yes, No or missing’ display “PLEASE CALL 1-888-SAFEFOOD
(1-888-723-3366) FOR ADDITIONAL INFORMATION]
PROG: NEW SCREEN]
44. Please provide any comments you wish. [PROG: Open-ended. Allow for up to 300 words]
File Type | application/msword |
File Title | 10-9-08 |
Author | tempuser |
Last Modified By | lverrill |
File Modified | 2012-08-24 |
File Created | 2012-08-24 |